Journal of Prevention and Treatment for Stomatological Diseases ›› 2017, Vol. 25 ›› Issue (4): 235-238.doi: 10.12016/j.issn.2096-1456.2017.04.007

• Cinical Study • Previous Articles     Next Articles

Teeth extraction with endotracheal intubation under general anesthesia in special needs patients-a retrospective analysis

Ke-xiong OUYANG(), ZOURui, HEJin-quan, HUANGLuo, ZHANGJun-wei, Zheng-guo PIAO()   

  1. Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Stomatology Hospital of Guangzhou Medical University, Guangzhou 510140, China
  • Received:2016-11-02 Revised:2016-11-25 Online:2017-04-20 Published:2018-09-03

Abstract:

Objective To discuss the demand and security of tooth extraction under general anesthesia with endotracheal intubation for the special needs patients. Methods From January 2014 to December 2015, the cases of tooth extraction under general anesthesia were collected to analyse the demand and security of tooth extraction with general anesthesia. Results 54 patients were recruited in the study in which 11 were with serious limitation of mouth opening, 10 were with serious cardiovascular disease risk, 2 were with history of epilepsy, 13 were with serious dental phobia, and 18 were incoordination patients. All the operations were performed successfully and safely, and all the scores of post anesthetic discharge scoring system exceeded 9 points. No developed complications were showed in 1 day, 1 week, 1 month follow-up. Conclusion Tooth extraction under general anesthesia with endotracheal intubation is a safe way for special needs patients.

Key words: Special needs, Tooth extraction, General anesthesia with endotracheal intubation, Complication, Special disease

CLC Number: 

  • R782

Figure 1

Classification of patients by sex and age"

Table 1

The characteristics of 54 cases of teeth extraction with endotracheal intubation under general anesthesia n"

分类 特点 数量
严重张口受限 长期颞下颌关节病导致的严重张口受限 5
幼年颌面外伤导致的颞下颌关节强直的小颌畸形而引起的严重张口受限 2
鼻咽癌放疗后导致的颌间瘢痕而引起的严重张口受限 4
严重心脑血管风险 高血压或有心脏病史,年龄大于等于60岁的老年患者,想一次性把较多的口内残根残冠拔除 10
癫痫病史 考虑其复发癫痫可能性 2
严重的牙科恐惧症 双侧上下颌智齿埋伏阻生,对牙科操作恐惧 13
不能配合治疗 年龄太小,口内需要处理的患牙较多,家长想一次性处理全部患牙 17
智力障碍,难沟通,且不配合操作 1
总计 54

Table 2

Postanesthetic discharge scoring system (PADSS)"

指标 评分 标准
生命体征 2分 血压、脉搏波动在术前水平20%以内
1分 血压、脉搏波动在术前水平20~40%以内
0分 血压、脉搏波动超过术前值40%
步行 2分 能确定方位并且步态稳健
1分 能确定方位或且步态稳健
0分 不能达到前两项中任何一项
恶心呕吐 2分 极少,或者无恶心呕吐
1分 中度,肌肉注射止吐药物可控制
0分 严重,重复用药不能控制
疼痛 2分 极少,无痛或者轻微疼痛
1分 中度,可忍受疼痛
0分 严重,不可忍受疼痛
创口出血 2分 极少,口腔内少量血丝
1分 中度,需要继续口腔内压迫止血
0分 严重,需要应用止血药物
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